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Resilience

      We all know those who we would characterize as psychologically resilient, those who demonstrate the great capacity to cope with extreme stress, catastrophe, and negative life events. We can recount several experiences in the lives of patients, students, colleagues, and friends that have led to displays of resilience. We might have even encountered these adverse life events ourselves and responded in ways that others would note as resilient.
      Of particular interest in both research and clinical practice are the long-term effects of traumatic events and the consequent resilient or nonresilient responses. Consider the research on children who lost a parent in the September 11, 2001, terrorist attacks in New York, for example. Researchers found that bereaved children, but not nonbereaved children, had significantly increased rates of psychiatric disorders involving anxiety disorders, especially posttraumatic stress disorder, after September 11, 2001, compared with retrospective assessments before September 11, 2001 (
      • Pfeffer C.R.
      • Altemus M.
      • Heo M.
      • Jiang H.
      Salivary cortisol and psychopathology in children bereaved by the September 11, 2001 terror attacks.
      ). There are several other studies on effects of traumatic life events that we could also cite, including the effects on adults, adolescents, and children. However, the important notation is that not everyone who experiences trauma has negative outcomes. Some individuals use their negative experience to develop a positive life. They demonstrate constant competence under stress or positive recovery from trauma and adapt successfully to negative life events.
      Well, it seems as if Norman Vincent
      • Peale N.V.
      The power of positive thinking.
      may have been correct in his preaching and writings about the “power of positive thinking” or what physician scientists
      • Charney D.S.
      • Nemeroff C.B.
      The piece of mind prescription: An authoritative guide to finding the most effective treatment for anxiety and depression.
      have called the “piece of mind prescription.” New research about positive thinking and resilience supports the “in-the-moment” value of positive emotions. These researchers found that the present experience of positive emotions formed the link between happiness and desirable life outcomes. In this study, resilience was related to development of resources for living well (
      • Cohn M.A.
      • Fredrickson B.L.
      • Brown S.L.
      • Mikels J.A.
      • Conway A.M.
      Happiness unpacked: Positive emotions increase life satisfaction by building resilience.
      ).
      The key question, beyond the need for more research, not just among healthy young adults as in the study of
      • Cohn M.A.
      • Fredrickson B.L.
      • Brown S.L.
      • Mikels J.A.
      • Conway A.M.
      Happiness unpacked: Positive emotions increase life satisfaction by building resilience.
      but also among survivors of trauma is what protective mechanisms can be learned through life experiences, counseling, or therapy. What can we do to help develop resilience. Social support, lack of vulnerability, and individual personality characteristics all may be involved, but repeatedly, support from others has been demonstrated as key to distinguishing those who are described as resilient. We know how to provide the support; psychiatric nurses are in a key position to develop and deliver programs for those who have experienced any kind of trauma. Not only are we in the frontline positions to do so, but also there is evidence throughout reports in this journal that our efforts are successful. Now, it is important to communicate our work to those in the broader health care community.

      References

        • Charney D.S.
        • Nemeroff C.B.
        The piece of mind prescription: An authoritative guide to finding the most effective treatment for anxiety and depression.
        Houghton Mifflin, NY2004
        • Cohn M.A.
        • Fredrickson B.L.
        • Brown S.L.
        • Mikels J.A.
        • Conway A.M.
        Happiness unpacked: Positive emotions increase life satisfaction by building resilience.
        Emotion. 2009; 9: 361-368
        • Peale N.V.
        The power of positive thinking.
        Prentice Hall, Upper Saddle River, NJ1952
        • Pfeffer C.R.
        • Altemus M.
        • Heo M.
        • Jiang H.
        Salivary cortisol and psychopathology in children bereaved by the September 11, 2001 terror attacks.
        Biological Psychiatry. 2007; 61: 957-965